2015-11-30

Out of the frying pan and into the fire

Or as Bilbo put it, escaping goblins to be caught by wolves.  After pretty much recovering from the meningitis and its psychological sequels, I stepped on a minute piece of glass in my kitchen.  Although I had bled a bit, my wife Gale got the glass out, and I went to the podiatrist to be fixed up.  The lesion was only 5 mm x 5 mm and 1 mm deep and looked fairly trivial.  But within three days, I had massive cellulitis (bacterial infection of the skin) in the foot and lower leg.  Foot trouble for diabetics is far worse than foot trouble for anyone else, and hey presto, I was back in the hospital being looked after by three separate teams of doctors: podiatry, infectious diseases, and family medicine (one of the analogues of general practice in the U.S.)

Heavy-duty antibiotics relieved the pain in the leg (I feel no pain, touch, or temperature sensations in my feet, though I do feel pressure) within a few days, but the external signs were still very ugly.  So my podiatrist decided to cut me open at the worst-looking spot, basically chopping from the top of my foot down almost to the sole.  Fortunately, I've had no pain from this.  More antibiotics and having my foot squeezed to get the pus out was pretty successful, and I was sent home after two weeks: a very different story from two days, but at least my mind wasn't affected this time.  Of course, I'd gone from an infected foot to a wounded one (the trivial cut on my sole had healed already), though at least the wound was clean and straight.

So I've been back at home for the last two weeks with a permanent IV line installed and a less comprehensive antibiotic, after I was found to have non-MRSA staph.  The surgical wound is healing better than expected: fortunately, my gross circulation is fairly unimpaired (you can feel strong pulses in my feet), so it's quite likely that I'll come out the other side essentially as well off as before. (I have two permanently broken toes on that foot, but the don't impair my walking.)  Meanwhile, I'm working from home and attending meetings by Skype, but only at 85% of full time thanks to all the doctors I have to visit repeatedly.  I'm walking on the heel of the bad foot using a surgical shoe (a sort of sandal with a very stiff sole) plus a crutch on the good side, and hopefully will be upgraded to something less restrictive after tomorrow.  Again hopefully, the IV will be terminated after Wednesday.

Oddly, no connection was ever found between the glass cut on my sole and all the pus in my foot, so just how the staph got into my foot remains completely unexplained.  Gale, who is not diabetic, had had cellulitis a month before, but she had a visible scratch on her leg, and two days in the hospital on IV fixed her right up.  Also, the cold I mentioned turned out to be an allergy, which nose drops are slowly clearing.  Nothing has been done about the low hemoglobin yet, and I also will have to see a vascular surgeon when I can walk again.